A 52-Year-Old Woman With an Abdominal Mass, Bilateral Pulmonary Nodules, and Mediastinal and Hilar Lymphadenopathy

Chest. 2019 Jun;155(6):e175-e178. doi: 10.1016/j.chest.2019.01.017.


A 52-year-old, nonsmoking, African-American woman with a history of obesity, hypertension, and rheumatoid arthritis was referred for workup of multiple bilateral pulmonary nodules. The pulmonary nodules were discovered incidentally while undergoing a CT scan for an abdominal mass that was radiographically diagnosed as a uterine leiomyoma. She was asymptomatic from a pulmonary standpoint without unintentional weight loss, fevers, or night sweats. Her mother and sister had a history of lung cancer. She was diagnosed with rheumatoid arthritis 5 years earlier that was controlled with adalimumab for approximately 3 years when she stopped being seen by her rheumatologist and discontinued adalimumab. During evaluation for the abdominal mass, she re-established care with a rheumatologist and was started on 40 mg prednisone daily with plans to restart adalimumab once the workup for the abdominal mass and pulmonary nodules was completed. She had undergone bariatric surgery with cholecystectomy approximately 5 years earlier, after which she experienced intentional postsurgical weight loss.

Publication types

  • Case Reports

MeSH terms

  • Diagnosis, Differential
  • Female
  • Humans
  • Inhalation Exposure / adverse effects*
  • Leiomyoma / pathology
  • Lymphadenopathy* / diagnostic imaging
  • Lymphadenopathy* / etiology
  • Mediastinum / diagnostic imaging
  • Middle Aged
  • Multiple Pulmonary Nodules* / diagnosis
  • Multiple Pulmonary Nodules* / etiology
  • Multiple Pulmonary Nodules* / physiopathology
  • Pneumoconiosis* / diagnosis
  • Pneumoconiosis* / etiology
  • Pneumoconiosis* / physiopathology
  • Positron Emission Tomography Computed Tomography / methods
  • Spectrum Analysis / methods
  • Talc / adverse effects*
  • Thorax / diagnostic imaging*
  • Uterine Neoplasms / pathology


  • Talc